<!DOCTYPE html5>
<html lang="en">
<head>
    <meta name="keywords" />
    <meta name="description" />
    <meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
    <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1" />
    <meta name="format-detection" content="telephone=no" />
    <meta name="renderer" content="webkit" />
    <meta name="viewport" content="width=device-width, initial-scale=1, minimum-scale=1, maximum-scale=1" />
    <link type="text/css" href="<?= $this->__STATIC__?>images/favicon.ico" rel="shortcut icon" />
    <link type="text/css" href="<?= $this->__STATIC__?>css/base.css" rel="stylesheet" />
    <link type="text/css" href="<?= $this->__STATIC__?>css/page.css" rel="stylesheet" />
    <link type="text/css" href="<?= $this->__STATIC__?>css/swiper.min.css" rel="stylesheet" />
    <script type="text/javascript" src="<?= $this->__STATIC__?>js/jquery.min.js"></script>
    <script type="text/javascript" src="<?= $this->__STATIC__?>js/swiper.min.js"></script>
    <script type="text/javascript" src="<?= $this->__STATIC__?>js/layer/layer.js"></script>
    <title></title>
    <link rel="stylesheet" href="../css/page.css">
</head>
<body>
<?php require $this->__RAD__ . 'include/header.php';?>
<div class="ny-banner" style="background:url(<?= $this->__STATIC__?>images/banner01.jpg) no-repeat top center;background-attachment:fixed;">
    <div class="wenz">
        <h2 class="h2 TwCenMT">contact us</h2>
        <hr>
        <h3>联系我们</h3>
    </div>
</div>
<div class="sub-nav">
    <div class="wrapper">
        <a href="/contact/">联系方式</a>
        <a href="/contact/feedback.html" class="cur">留言板</a>
    </div>
</div>
<div class="contact feedback">
    <div class="wrapper">
        <h2>填写您的留言信息</h2>
        <p>
            我们将尽快给与您反馈 <span>（注：带<font color="#fe0000"> * </font>符号的内容为必填选项）</span>
        </p>
        <div class="form clearfix">
            <form>
                <div class="input">
                    <em>*</em>
                    <input type="text" style="background:url(<?= $this->__STATIC__?>images/icon06.png) no-repeat left 20px center;" placeholder="您的姓名">
                </div>
                <div class="input">
                    <input type="text" style="background:url(<?= $this->__STATIC__?>images/icon07.png) no-repeat left 20px center;" placeholder="您的手机/电话">
                </div>
                <div class="input">
                    <em>*</em>
                    <input type="text" style="background:url(<?= $this->__STATIC__?>images/icon08.png) no-repeat left 20px center;" placeholder="您的邮箱">
                </div>
                <div class="input">
                    <em>*</em>
                    <input type="text" style="background:url(<?= $this->__STATIC__?>images/icon13.png) no-repeat left 20px center;" placeholder="公司">
                </div>
                <div class="input">
                    <input type="text" style="background:url(<?= $this->__STATIC__?>images/icon14.png) no-repeat left 20px center;" placeholder="部门/职位">
                </div>
                <div class="input">
                    <select style="background:url(<?= $this->__STATIC__?>images/icon0010.png) no-repeat left 20px center,url(/images/xl.png) no-repeat right 20px center;">
                        <option>主题</option>
                        <option>服务支持</option>
                        <option>制剂产品</option>
                        <option>原料药产品</option>
                        <option>应聘</option>
                        <option>其它</option>
                    </select>
                </div>
                <div class="input wid100">
                    <em>*</em>
                    <textarea style="background:url(<?= $this->__STATIC__?>images/icon09.png) no-repeat left 20px top 15px;" placeholder="留言内容"></textarea>
                </div>
                <!--
                <div class="input yzm">
                    <input type="text" placeholder="请输入验证码">
                    <img src="<?= $this->__STATIC__?>images/icon10.png">
                </div>
                -->
                <div class="input wid100">
                    <input type="submit" class="submit" value="提交留言">
                </div>
            </form>
        </div>

    </div>
</div>






<?php require $this->__RAD__ . 'include/footer.php';?>

</body>
</html>
<script type="text/javascript" src="<?= $this->__STATIC__?>js/common.js"></script>